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Biomedical subjects

I A Shameem

Publications and source records attributed to I A Shameem.

8 recordsLinked to original sources

Intravesical adjuvant therapy using mitomycin C.

Bladder cancer is mostly superficial at first diagnosis. High incidence of recurrence is the major problem after initial management with transurethral resection (TUR) of bladder tumor. Adjuvant chemotherapy has been advocated to reduce the incidence of recurrence. A study was carried out to observe the efficacy of intravesical adjuvant therapy with single immediate versus delayed multi-dose regimen of Mitomycin C (MMC) in preventing recurrence of superficial bladder cancer. One hundred Patients having intermediate risk superficial bladder cancer were randomized into two equal groups. All patients were followed carefully. Total duration of follow-up was minimum 12 months, maximum 36 months, mean 29 months. No recurrence was seen on 3(rd), 6(th) and 9(th) month of intravesical therapy. As much as 94% and 96% of recurrence free rate was observed in immediate single and delayed multi-dose group respectively on 12(th) month; 86% and 84% on 18(th) month; 74% and 72% on 24(th) month; 70% and 68% on 36(th) month of follow-up cystoscopy respectively. Efficacy of post transurethral resection of bladder tumour (TURBT) MMC single immediate dose was found similar to that of MMC delayed multi-dose regimen in preventing the recurrence of intermediate risk superficial bladder transitional cell carcinoma (TCC) in the study. The difference between the two groups insignificant (p>0.05).

Administration, Intravesical↗

Necessity of antibiotics prophylaxis during extracorporeal shock wave lithotripsy.

A total of 360 patients with renal and ureteral calculi who had sterile urine before extracorporeal shock wave lithotripsy (ESWL) and did not have any increased risk of infection received Tab. Ciprfloxacin (500 mg) 12 hourly for the next 5 days or no prophylaxis were included in this prospective study. Patients were followed by urinalysis and culture together with clinical evaluations. In antibiotic prophylactic group 10 (6.4%) had post ESWL urine culture positive while in without prophylaxis 13 (8.8%) had positive urine culture. The incidence of urinary tract infection after ESWL is extremely low, provided that patients have sterile urine before the procedure.

Adult↗

Efficacy of terazosin and finasteride in symptomatic benign prostatic hyperplasia: A comparative study.

Medical treatment for symptomatic Benign Prostatic Hyperplasia (BPH) has become popular for the last few years. This study was designed to find out and compare the efficacy of terazosin, a alpha1 adrenoceptor blocker and finasteride, a 5alpha-reductase inhibitor in symptomatic BPH. A total of 60 patients (30 in terazosin group and 30 finasteride group) of symptomatic BPH were selected. Terazosin group received 1 mg daily at bedtime for 3 days, 2 mg at bedtime for 7 days, thereafter 5 mg at bedtime daily for 6 months. Finasteride group received 5 mg once daily. In terazosin treated patients, improvement after 3 months were as follows, IPSS 3.93 +/- .74 points reduction, Qmax 2.13 +/- .68 ml/s increase, post-voided residual urine volume (PVR) 20.67 +/- 10.56 ml reduction (significant, p<0.001) and prostate volume 0.57 +/- 1.54 ml reduction (not significant). Similar statistical differences were observed at 6 months follow up. In finasteride treated patients, improvements after 3 months were as follows, International Prostate Symptom Score (IPSS) 1.38 +/- .63 points reduction, Qmax 0.55 +/- 0.78 ml/s increase, PVR 5.93 +/- 7.64 ml reduction (significant, p<0.001) and prostate volume 0.17 +/- 5.6 ml reduction (non-significant). At 6 month follow up statistical differences were significant in all parameters including prostate volume 4.57 +/- 5.30 ml reduction (p<0.001). In comparison, statistically significant superiority of terazosin over finasteride was found in improving IPSS, Qmax and PVR in both follow up visits. But terazosin had nonsignificant effect in reducing prostate volume; in contrast, finasteride had significant effect in second visit. It can be concluded from this study that terazosin 5mg once daily is effective in mild to moderate cases of symptomatic BPH. On the other hand, finasteride 5mg once daily may be useful in large prostate and to be given for at least 6 months.

Adrenergic alpha-Antagonists↗

Expression of proliferating cell nuclear antigen and deoxyribonucleic acid value in renal cell carcinoma: correlation with different histopathological parameters and patient survival.

Forty-six human renal cell carcinoma tissues obtained from radical nephrectomy, fixed in 10% formaldehyde solution and embedded in paraffin for histopathological examination were used for immunohistochemical staining of proliferating cell nuclear antigen (PCNA) using a monoclonal antibody PC10, and 37 of the 46 were also used for flow cytometric DNA ploidy analysis. PCNA-positive rates were compared with different histopathological parameters and patient survival. The relationships between the DNA ploidy and PCNA-positive rates and patient survival were also determined. Statistically significant differences in PCNA-positive rates were observed in different histopathological grades and stages of renal cell carcinoma. No relationship was observed between the PCNA-positive rate and DNA ploidy. For all cases analyzed, patients whose tumors had PCNA-positive rates of less than 10% survived statistically longer than those with tumors with PCNA-positive rates of 10% or more (p < 0.02). When patients were stratified by histopathological stage-I and grade-1 tumors, however, there was no significant difference between the PCNA-positive rate and survival. No difference in survival was observed according to DNA ploidy. The PCNA-positive rates showed a close relation to the different histopathological grades and stages of renal cell carcinoma. For all cases analyzed, high PCNA-positive rates showed poor prognosis. But for patients with histopathological stage-I and grade-1 tumors, the PCNA-positive rates and DNA ploidy did not provide independent prognostic information.

Adolescent↗

Direct and indirect effects of recombinant human granulocyte-colony stimulating factor on in vitro colony formation of human bladder cancer cells.

Although the present experimental use of recombinant human granulocyte-colony-stimulating factor (rG-CSF) has been proven to alleviate the myelosuppression induced by antitumor chemotherapy, it is also believed to stimulate growth of some nonhematopoietic tumor cells. We investigated both the direct and indirect effects of rG-CSF on in vitro colony formation of human bladder cancer cell lines using a modified human tumor clonogenic assay. Peripheral blood mononuclear cells (PBMC) were used as feeder cells (a mixture of 5 x 10(4) monocytes/dish and 5 x 10(5) lymphocytes/dish obtained from healthy donors). Human bladder cancer cell lines KK-47, TCCSUP and T24, all derived from human transitional-cell carcinomas, were incubated continuously with various concentrations of rG-CSF ranging from 0.01 ng/ml to 10 ng/ml both with and without PBMC for 7-21 days. The concentrations of rG-CSF used were chosen as being in the range of achievable serum concentrations in patients treated with rG-CSF. At the end of incubation, colonies were counted under an inverted phase-contrast microscope, and an increase in the number of colonies in comparison with the control was used to evaluate the effects of rG-CSF. Results were expressed as a percentage of controls. rG-CSF in the upper layer at concentrations ranging from 0.1 ng/ml to 10 ng/ml stimulated the colony formation of all the cancer cell lines tested in the absence of PBMC in the feeder layer, whereas cells with PBMC in the feeder layer were significantly stimulated more than those without PBMC in the feeder layer (P < 0.05) up to a certain concentration, which varied from cell line to cell line. At higher concentrations of rG-CSF, no further stimulation but, on the contrary, a decrease in colony formation was observed in cells with PBMC in the feeder layer in all the cell lines tested. Colony formation in KK-47 and T24 cell lines was significantly inhibited at 5 ng/ml and/or 10 ng/ml rG-CSF compared with cells without PBMC in the feeder layer. Our results suggest that rG-CSF may have both direct and indirect stimulatory effects on the growth of human bladder cancer cell lines in vitro. The results obtained also raise the possibility of adverse effects of rG-CSF in bladder cancer patients whose malignant cells may be directly and indirectly stimulated by this factor while it is being used clinically to alleviate the myelosuppression induced by antitumor chemotherapy.

Cell Division↗

[Expression of proliferating cell nuclear antigen in superficial bladder cancer--application to paraffin-embedded tissue sections].

It is important to know the proliferating ability and the malignant potential of each tumor. We studied 56 cases of pTa to pT1 superficial bladder tumors using immunohistochemical staining for proliferating cell nuclear antigen (PCNA), and compared the results with the clinical course of each patient. We obtained the following results. 1) We detected the PCNA positive nuclei in all cases, and the PCNA positive rates varied within a range of 1.1-77.5% with a mean of 34.0%. 2) The PCNA positive rate showed no correlation with age, sex, duration of paraffin-embedded, or pathological stage, but showed a significant correlation with the number of tumors, pathological grade of malignancy, or non-recurrence rate. PCNA positive rate of Grade 1 cases (n = 19, 15.6%: mean) was significantly lower than those of Grade 2 cases (n = 27, 39.9%) or Grade 3 cases (n = 10, 53.1%) (P < 0.01). The recurrence rate of the cases with PCNA positive rates of more than 34% (n = 24) was significantly higher than that of the cases with a PCNA positive rate of less than 34% (n = 32) (P < 0.05). In conclusion, the method of counting the rate of PCNA positive nuclei is considered to be very useful because of its applicability to paraffin-embedded tissue sections and the simple and rapid techniques. Our results in bladder cancer tissues suggest that this method may also be useful for investigating the proliferating ability and the malignant potential of tumors in general.

Adult↗

[Analysis of proliferating cell nuclear antigen and nucleolar organizer region in testicular tumors].

Immunohistochemical staining using the monoclonal antibody of proliferating cell nuclear antigen (PCNA) and argyrophilic nucleolar organizer region associated protein (AgNOR) staining were performed on 28 paraffin-embedded testicular tumors, and their correlation was assessed according to histological type, clinical staging and tumor markers. PCNA positive rates and AgNOR numbers in nuclei were 57.9%, 4.38 in seminomas, 63.4%, 5.79 in embryonal carcinomas, 37.7%, 2.63 in teratomas, 61.3%, 4.43 in yolk sac tumors, 79.5%, 7.12 in choriocarcinomas, and 20.9%, 3.03 in cells of the normal seminiferous tubule, respectively. In pure seminomas, the PCNA positive rates and AgNOR numbers of the stage II to III group (72.6%, 4.75) were higher than those of the stage I group (47.8%, 3.67), but there was no significant difference between the two groups. There was a significant correlation between PCNA positive rate and AgNOR number in all specimens (r = 0.76, p < 0.002). These findings indicate that PCNA and AgNOR are suitable indicators for proliferative activity of testicular tumors.

Adult↗

Hyperbaric oxygen therapy for control of intractable cyclophosphamide-induced hemorrhagic cystitis.

We report a case of intractable hemorrhagic cystitis due to cyclophosphamide therapy for Wegener's granulomatosis. Conservative treatment, including bladder irrigation with physiological saline and instillation of prostaglandin F2 alpha, failed to totally control hemorrhage. We then used hyperbaric oxygen at an absolute pressure of 2 atm, 5 days a week for 8 consecutive weeks. The bleeding ceased completely by the end of treatment and the patient remained free of hematuria thereafter. No side effect was noted during the course of therapy. In future, this form of therapy can offer a safe alternative in the treatment of cyclophosphamide-induced hemorrhagic cystitis.

Cyclophosphamide↗