Metastatic breast cancer to the bladder: a case report.
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Biomedical subjects
Publications and source records attributed to C Mallouh.
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Addition of IFN-beta resulted in a dose-dependent reduction of growth, a drop in [3H]thymidine incorporation into DNA, and a concurrent 69% and 15% increase in the S and G2/M phases, of the human prostatic JCA-1 cells. No correlation existed between the antimitogenicity of IFN and increases in the double-stranded RNA-dependent protein kinase activity. Although IFN elicited a large increase in 2-5A synthetase activity, activation of the 2-5A-dependent RNase L could not be demonstrated in JCA-1 cells rendered permeable to 2-5A, implying that the 2-5A pathway is not involved in the anti-proliferative effects of IFN. Analysis of endogenous proteins phosphorylated in vitro show that some IFN-inducible phosphoproteins were dependent upon the presence of double-stranded DNA.
The proliferation of the human prostatic cancer JCA-1 cells showed a complex response to different concentrations of TPA. Whereas cells exposed for 24 h had growth reduction which was proportional to the concentration of TPA added to the culture media, they showed resistance to low (0.016 and 0.16 nM) but not high (> or = 1.6 nM) doses of TPA after 72 h. Growth-inhibited, treated cells also displayed a distinct cell morphology compared with the controls. Since c-myc expression has previously been shown to be correlated with cellular proliferation, we determined changes in its steady-state level in control and treated cells by Northern analysis. Following a 24h, 48h, and 72h treatment, with 16 nM TPA, c-myc mRNA was suppressed by 91%, 83%, and 78%, respectively, in good agreement with the extent of growth reduction observed. At the low dose of TPA (0.16 nM), however, the c-myc mRNA expression remained inhibited by 85% even though cell growth was only reduced by 10-14%. No difference in the total amount of c-myc protein could be detected between control and treated cells by Western analysis.
We report on 4 women ages 31 to 65 years with adenocarcinoma of urethral diverticulum. One patient presented with metastatic disease and died after refusing post-radiation surgery. The other 3 women were without evidence of disease 9 to 44 months after diverticulectomy with radiation (1) or radical surgery (2). Review of our 4 cases and 64 cases documented in the literature showed that irritative voiding symptoms and hematuria were the most common findings. A palpable urethral mass was described in only 56% of reported cases but was observed in all of our patients, with the smallest mass measuring 2 x 2 cm. Urethroscopy with biopsy is the most important diagnostic test. Aggressive treatment is appropriate in most patients, since local recurrence has been documented in 44% of those treated by diverticulectomy and/or radiation.
A 14-year-old boy had multiple prostatic calculi and marked ballooning of the prostatic urethra during micturition secondary to a type III urethral valve. There were minimal changes in the bladder and upper tract. Resection of the valve corrected the patient's symptoms and signs.
A two centimeter left capillary renal haemangioma caused massive haematuria in a 27-year-old male with left hydronephrosis and nephrolithiasis. Nephrectomy for life threatening haemorrhage was performed. Diagnostic algorithms for the evaluation of adult onset gross haematuria and "essential" haematuria with a review of the current literature are presented.
Atypical prostatic cancer is defined as any malignancy of prostatic origin, excluding the common acinar prostatic adenocarcinoma. These atypical prostate cancers account for less than 5 percent of all prostatic malignancies. Because atypical prostatic malignancies occur rarely, little is known about their biologic behavior. To date, no large series of patients have been reported, and specific treatment protocols have yet to be defined. Herein we describe 5 new cases of atypical prostatic cancer. By reporting the occurrence of new cases, we believe a better understanding of the natural history of these lesions will emerge.
A case of chronic follicular pyeloureteritis is presented. This rare lesion, not previously published in the American literature, must be differentiated from primary renal lymphoma and generalized malignant lymphoma of the nonHodgkin type.
A consecutive sample of 16 women with laparoscopy-diagnosed endometriosis were evaluated for mood disorders. Twelve women met DSM-III criteria for a mood disorder: seven for bipolar disorder, mixed, three for bipolar disorder, manic, and two for major depression. Two women had equivocal diagnoses and two showed no evidence of mood disorder. Nine subjects had first-degree relatives with histories of severe mood disorders.
We report on a child who was born with a large unobstructed bladder with normal trigone and normal ureteral insertions. The differences between vesical gigantism and the congenital megacystis-megaureter syndrome are discussed. In our patient, reduction cystoplasty was efficacious in alleviating the child's symptoms and recurrent urinary tract infections. More cases would be of benefit in confirming the usefulness of this procedure.
Cardiovascular physiologic monitoring was undertaken in 12 patients undergoing transurethral resection of the prostate with the aid of flow-directed Swan-Ganz catheter and the Automated Physiologic Profile. Cardiac and pulmonary pressures and physiologic parameters were derived pre- and postoperatively. Resecting time, body temperature, intravenous fluid administered, serum hemoglobin, and sodium also were recorded. Of the 12 patients studied, 66 per cent experienced a drop in their cardiac index as well as their left ventricular function after surgery. Myocardial function curves revealed that 7 patients (58 per cent) had decreased cardiac function, 2 had no change, and 3 had increased function. Four patients with preoperative pulmonary wedge pressures (PAW) over 9 mm. Hg experienced depressed cardiac function. Three patients were resected for over sixty minutes, and all experienced depressed cardiac function. Vital signs, serum hemoglobin, or serum sodium did not reflect this change. We believe that relative hypervolemia, undetected elevation of pulmonary wedge pressure. We believe that relative hypervolemia, undetected elevation of pulmonary wedge pressure, and prolonged resection are factors that depress cardiac function and increase the risk of cardiovascular complication in transurethral surgery.
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The desire to give birth and nurture can be significant for women with mental illness and substance-abuse disorders, despite the many internal and external barriers to the effective achievement of these desires. This article provides information on the effect of coexisting mental illness and alcohol or other drug dependency on pregnancy from a medical, obstetric, psychiatric, and psychologic perspective. The article also explores the effect on parenting and highlights the need to assess for parental competency in this population. Treatment planning, including the use of psychotropic medication and the need for collaboration between providers is discussed.
To gain mechanistic insights into the growth control of renal cell carcinoma cells by IFN-gamma and TGF-beta, a recently established human renal carcinoma TC-1 cell line was treated with different concentrations of IFN-gamma and TGF-beta. Cell growth and changes in specific gene expression were evaluated. IFN-gamma exerted an antimitogenic effect on TC-1 cells, whereas TGF-beta was essentially without effect. The growth-suppressed cells had reduced expression of proliferating cell nuclear antigen (PCNA), the G2/M cell cycle transition regulatory proteins cyclin B/p34cdc2, the tumor suppressor gene pRB, and the antimetastatic gene nm23. However, levels of other cell cycle regulatory protein molecules such as cyclin D and p53 were unaffected by IFN-gamma. Thus, the antimitogenic effect of IFN-gamma may be mediated by its ability to modulate specific oncogene changes.
To gain insights into the involvement of kinases in the growth control of prostate carcinoma cells by the phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA), immunoblot analysis and in vitro phosphorylation assays were performed using kinase discriminating effectors and extracts prepared from the androgen-dependent LNCaP and the androgen-independent JCA-1 human prostate cells. The down-regulation of PKC-alpha and -beta in JCA-1 cells was correlated with the effects of TPA. In LNCaP cells, proliferation may involve DNA-PK, proposed to act possibly via phosphorylation of the androgen receptor.
Treatment of the JCA-1 prostate cells with different concentrations of microtubule inhibitors-taxol (paclitaxel) vinblastine, and estramustine-was accompanied by reduced cell growth and, correspondingly, characteristic morphological changes. The reduction of cellular proliferation was unlikely to be attributable to an inhibitory effect of the antimicrotubule agents on cell cycling, but was correlated with the decreased expression of the p53 gene. These results suggest that antimicrotubule agents may be considered as potentially complementary treatment modalities for patients with hormonally independent prostate cancer.