Reduced E-cadherin expression as a prognostic factor in non-muscle-invasive bladder cancer: A systematic review and meta-analysis

Introduction and objectivesThe exact role of E-cadherin in non-muscle-invasive bladder cancer (NMIBC) is still unknown, and the aims of this study were to prove whether reduced E-cadherin expression can be a prognostic factor in patients with NMIBC.Materials and methodsA meta-analysis was conducted to assess the prognostic value of reduced E-cadherin expression in NMIBC. The PubMed, Embase and Web of Science databases were included in the study search.ResultsFifteen studies with a total of 1538 NMIBC patients were included. The results showed that reduced E-cadherin expression was significantly associated with poor recurrence-free survival (RFS) (pooled HR 2.16, 95% CI 1.22–3.85) and progression-free survival (PFS) (pooled HR 1.91, 95% CI 1.52–2.40) in NMIBC patients.ConclusionE-cadherin can be a prognostic factor for patients with NMIBC.     

Reiter’s syndrome following intravesical bacille bilié de Calmette–Guérin treatment for superficial bladder carcinoma: report of six cases

Abstract

We report the cases of six patients who developed acute Reiter’s syndrome following intravesical bacille bilié de Calmette–Guérin (BCG) immunotherapy for superficial bladder cancer. After the third to eighth BCG intravesical injection, the patients developed conjunctivitis, aseptic urethritis, and polyarthritis consistent with a diagnosis of Reiter’s syndrome. HLA-B27 antigen was negative in five of the patients examined. Two of the patients responded to nonsteroidal anti-inflammatory drugs for polyarthritis, and the other four responded to steroids (prednisolone 5–10?mg/day). The frequent use of intracavitary BCG may increase the incidence of BCG-induced Reiter’s syndrome. Further analysis of the relationship between HLA-B and -DR alleles and arthritis should shed light on the mechanism of BCG-induced Reiter’s syndrome.     

Angiotensin-converting enzyme and diabetes mellitus

Elevation of serum angiotensin-converting enzyme (ACE) has been reported to occur in 25 p. 100 of diabetic patients. This finding would decrease the specificity of increased ACE level in sarcoidosis. We measured serum ACE in 90 diabetic patients with simultaneous analysis of various parameters including those appreciating the degree of metabolic control. Serum ACE values, observed in diabetics are not different from values measured in controls, respectively 22,3 +/- 6,4 and 21,1 +/- 6,7 U/ml (means +/- SD). Only 5,5 p. 100 of diabetic patients had (slightly) increased serum ACE levels, i.e.: levels above mean +/- 2 SD of values observed in controls. Serum ACE levels were higher in insulin-dependent diabetics: 24,7 +/- 6,7 (n = 34) than in non insulin-dependent diabetics: 20,8 +/- 5,9 (n = 56) (p = 0,01). In the diabetic group, there is a positive linear correlation between serum ACE level and 24h-glycosuria or glycosylated A1c hemoglobin. These are parameters appreciating middle or long-term metabolic control. In the other hand, no correlation was observed between serum ACE and glycemia, triglyceridemia, serum creatinin, blood pressure or the presence of diabetic retinopathy. These findings do not show an elevation of serum ACE in diabetic patients. However, they suggest that long-term metabolic control of diabetes influence serum ACE level.     

Fertility of tomorrow: Are there any restrictions left?

As the concepts of society, parenthood and family evolve, the French law on bioethics has recently been updated by authorizing oocyte and sperm cryopreservation for all individuals who wish to do so, in the absence of medical indications. For women, aging irremediably impairs reproductive competence, both quantitatively and qualitatively. For men, aging has a negative impact on sperm parameters. Hence, this possibility of social oocyte/sperm freezing is a real breakthrough, offering to all the opportunity to better anticipate age-related fertility decline and be better actors of one's reproductive life. In its current form, the new French bioethics law allows unrestricted access to fertility preservation techniques to all women and men that fulfill the age criteria. In light of the lack of official recommendations, many questions remain. In clinical practice, it is therefore up to centers to determine on a case-by-case basis the limits of these procedures, notably to define when to stop fertility preservation. This also questions the place of the patient as a decision maker in the procedure and to which extent these procedures should be performed according to patient preference. Altogether, despite the wide range of possibilities enabled by these major legal and technical advances, it is essential to make clear to all that undergoing fertility preservation procedures is not a guarantee of future pregnancy and does not replace timely care of fertility issues.     

Electron dense alteration of kidney basement membranes: A renal lesion specific of a systemic disease

Described here are the findings of a clinical, anatomic and chemical study of 40 patients having an original lesion of the basement membranes of the kidney.This lesion is characterized by an ultrastructural modification of the basement membrane substance which appears very dark (black) and homogeneous in electron micrographs. It affects the basement membranes of the glomerulus, Bowman's capsule and the renal tubules. Patients with this lesion all manifest the clinical course of a chronic nephritis and is almost invariably accompanied by proteinuria and microscopic hematuria. The disease evolves generally with intermittent episodes towards irreversible renal failure.Eight patients received kidney transplants. Study of these transplants has shown that the lesion recurs in the transplanted kidneys during the year following transplantation. Moreover, it is never found in kidneys transplanted into patients who did not have it in their own kidneys. This ultrastructural lesion can therefore be placed in the framework of a systemic disease whose etiology is not yet known. The study of these transplants also shows that the lesion can exist despite the absence of any detectable clinical or biologic signs and be well tolerated for periods which now exceed 4 years for three patients.     

Experimental cystinuria: The cycloleucine model. II. Amino acid efflux from intestinal and renal tissues

Loading and unloading experiments using intestinal sacs and renal cortex slices were undertaken to ascertain the role of amino acid efflux in cycloleucine-induced amino-aciduria. The presence of cycloleucine, lysine, or valine on the luminal or antiluminal side of the intestine caused an increased leakage of [¹⁴C] cycloleucine, [¹⁴C] lysine, and [³⁵S] cystine from the tissue. Similar results were obtained when using kidney cortex slices, except for cystine efflux. The latter phenomenon was inhibited by cycloleucine and lysine. Data, also obtained with renal cortex slices, suggest that cystine and cysteine are recognized by different transport sites although one (the oxidized form) may be typically extracellular and the other (the reduced form), intracellular. A comparison of these data with previous works done in our laboratory¹⁴ shows that cycloleucine affects efflux less than influx and further suggests that in rats given cycloleucine, renal transport is impaired only at the brush border level for cystine and at both luminal and antiluminal membranes for dibasic amino acids.     

Sinus slowing produced by experimental ischemia of the sinus node in dogs

The effects on heart rate and rhythm of acutely impeding the blood supply to the sinus node were studied in 18 anesthetized dogs. In 8 dogs the blood supply to the sinus node appeared to originate from 1 main artery, whereas more than 1 source was found in the remaining animals. When the sinus node was supplied by a single main artery, ligation of this artery was followed by a decrease in heart rate whereas, when a multiple blood supply to the sinus node was observed, it was necessary to occlude all major arteries to affect sinus nodal function. The effects observed did not seem related to activation of coronary stretch-sensitive receptors or to local or reflex activation of cholinergic nerve terminals within the sinus node.