Granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin instillation therapy

We report a rare case of granulomatous balanoposthitis after intravesical Bacillus-Calmette-Guerin (BCG) instillation therapy in a 58-year-old man, which followed transurethral resection (TUR) for recurrent bladder cancer, when his anterior urethra was slightly narrow and his foreskin was with phimosis. Intravesical BCG instillation therapy was started for prophylaxis of recurrent bladder cancer after TUR. Multiple painless firm papules on glans penis, edema in the foreskin and low-grade fever appeared after the seventh instillation, for which the single antituberculous agent isoniazid (300 mg/day) was administered. Biopsy of the papules on glans penis and foreskin revealed granulomatous balanoposthitis. Low-grade fever normalized and the papules disappeared within 1 week. The patient continued chemotherapy with isoniazid for the next 12 months. There was no recurrence of bladder cancer or balanoposthitis for 15 months and to date.     

Urothelial carcinoma (clear cell variant) diagnosed with useful immunohistochemistry stain

The case is reported of urothelial carcinoma (clear cell variant) that was diagnosed with useful immunohistochemistry stain. A 70-year-old man, who had undergone left radical nephrectomy for renal cell carcinoma in August 2003 and partial lobectomy for pulmonary metastasis in May 2005, complained of hematuria in June 2005. On evaluation, a papillary pedunculated tumor was detected in the left wall of the urinary bladder. A transurethral resection of the bladder tumor (TUR-Bt) was performed in July 2005. The pathological diagnosis was difficult due to diffuse clear cell appearance. Immunohistochemistry stain showed urothelial carcinoma, not metastasis of the renal cell carcinoma. Finally it was diagnosed as urothelial carcinoma clear cell variant. Urothelial carcinoma has many variants that show a variety of appearances and characteristics. These should be well known before medical therapy is initiated.     

Imaging characteristics of papillary renal cell carcinoma by computed tomography scan and magnetic resonance imaging

AIM: To analyse the differences in the patterns between clear and papillary renal cell carcinomas using magnetic resonance imaging (MRI) and dual-phase helical computed tomography (CT). METHODS: We examined seven patients with papillary renal cell carcinoma, and six with clear cell carcinoma. The highest attenuation value of tumors in the corticomedullary phase (CMP) and the excretory phase (EP) was measured using the observer-defined region of interest (ROI). MRI consisted of T1-weighted and T2-weighted spin-echo imaging. RESULTS: All five tumors except for one with papillary renal cell carcinoma showed homogenous hypointensity, but all six tumors with clear cell carcinoma showed heterogeneous hyperintensity on their T2-weighted images. In the CMP, the mean CT numbers of the papillary renal cell carcinomas were significantly lower than those of the clear cell carcinomas. The mean enhancement of the papillary renal cell carcinomas in the CMP and the EP was significantly lower than that of the clear renal cell carcinomas. The mean CT numbers of the clear cell carcinomas in the CMP were markedly increased from those on the unenhanced CT; those in the EP were decreased gradually. But the mean CT numbers of the papillary renal cell carcinomas in the EP were still slightly more increased than those in the CMP. The enhancement patterns of the papillary renal cell carcinomas in the CMP and the EP were homogenous, but those of the clear cell carcinomas were heterogeneous. CONCLUSIONS: We can speculate the differential diagnosis from clear to papillary renal cell carcinoma using MRI and dual-phase helical CT.     

ULTRASTRUCTURAL CHANGE OF THE GLOMERULAR BASEMENT MEMBRANE IN RATS WITHHEYMANN NEPHRITIS REVEALED BY ULTRAHIGH RESOLUTION SCANNING ELECTRON MICROSCOPY

To assess the relationship between the glomerular injury induced by immune complex deposition and proteinuria, ultrastructural changes of the glomerular basement membrane (GBM) were investigated in Heymann nephritis. Active Heymann nephritis was induced in rats by injecting them with tubular brush border antigen, known as Fx1A, emulsified in complete Freund's adjuvant (CFA). Measurement of urinary protein excretion and histological examinations were carried out for up to 15 weeks after immunization. Proteinuria developed in rats within 10 weeks of immunization and coincided with the development of subepithelial deposits with minimal spike-like basement membrane protrusion. Acellular glomeruli were prepared by detergent treatment and were subjected to tannic acid–osmium conductive staining prior to examination with an ultrahigh resolution scanning electron microscope (HSEM). HSEM of the acellular GBM prepared from control rats injected with CFA alone revealed a meshwork structure, with pores of about 9 nm in diameter. Proteinuric rats immunized with Fx1A showed a loosened meshwork structure, with pores of about 15 nm in the acellular GBM adjacent to the deposits. The newly formed GBM overlying the deposit consisted of a meshwork structure associated with unorganized thin fibrils. Ultrastructural changes were never seen in GBM devoid of deposits. These findings indicate that subepithelial deposits are closely involved in the development of proteinuria by injuring the size selectivity of the GBM.     

人白细胞介素1β通过线粒体途径激活caspase-3诱导A375-S2细胞凋亡

目的研究人白细胞介素1β(Interleukin-1β,IL-1β)体外诱导人黑色素瘤A375-S2细胞凋亡的机制。方法通过Hoechst33258荧光染色,观察A375-S2细胞在IL-1β作用下的形态学变化。使用琼脂糖凝胶电泳法检测IL-1β对细胞DNA降解的影响。应用caspase活力测定法检测IL-1β对caspase-3活力的影响。利用Westernblot方法检测IL-1β对caspase-3底物的降解以及对细胞内Bcl-2家族和AIF蛋白表达的调节作用。结果IL-1β(1nmol/L)能够诱导A375-S2细胞凋亡,72h时细胞体变小,细胞核呈现固缩、断裂,并出现因凋亡引起的DNA梯状条带。IL-1β诱导细胞凋亡过程中,caspase-3的活力升高,其两种底物PARP和ICAD均发生降解,线粒体中抗凋亡蛋白Bcl-2和Bcl-xL的表达减少,促凋亡蛋白Bax的表达增加。凋亡诱导因子AIF蛋白的表达也有所增加。结论IL-1β通过激活caspase-3降解其底物,激活AIF,并上调线粒体内Bax/Bcl-2和Bax/Bcl-xL的表达比例诱导A375-S2细胞凋亡。     

血竭素高氯酸盐诱导人宫颈癌HeLa细胞凋亡的机制

目的研究血竭素高氯酸盐诱导HeLa细胞凋亡机制。方法MTT法测定血竭素高氯酸盐对HeLa细胞的细胞毒作用。通过显微镜，荧光染色观察细胞形态学变化，用琼脂糖凝胶电泳检测DNA片断化。用Western印迹法分析药物对蛋白质表达的影响。结果血竭素高氯酸盐明显抑制HeLa等细胞的增殖，诱导HeLa细胞调亡。Caspase-1，-3，-8，-9及家族抑制剂可明显抑制血竭素高氯酸盐诱导的凋亡。Western印迹结果显示血竭素高氯酸盐作用12 h后Bax及Bcl-X_L的表达明显改变，caspase-3，-8前体及caspase-3底物ICAD和PARP发生降解。结论血竭素高氯酸盐(60 μmol·L^-1)通过改变Bax/Bcl-X_L的表达激活caspase途径诱导HeLa细胞凋亡。     

冬凌草甲素通过诱导人宫颈癌HeLa细胞自噬下调凋亡的机制

研究冬凌草甲素通过诱导人宫颈癌HeLa细胞自噬拮抗凋亡的机制。MTT法测定冬凌草甲素对HeLa细胞的细胞毒作用。通过相差显微镜观察细胞形态学变化，用琼脂糖凝胶电泳检测DNA片段化，用流式细胞仪检测细胞自噬和凋亡水平，用Western blotting检测分析药物对蛋白质表达的影响。冬凌草甲素明显抑制HeLa细胞的增殖，诱导HeLa细胞凋亡，同时诱导HeLa细胞发生自噬。Western blotting检测结果表明，冬凌草甲素作用24 h后，促凋亡蛋白Bax、细胞色素c和控制Bax活力的去乙酰化酶SIRT-1的表达明显改变。冬凌草甲素(64 μmol·L^-1)诱导的自噬通过影响SIRT-1和线粒体途径蛋白的表达下调凋亡。     

松杉灵芝菌丝体多糖(FI_0-b)对人组织瘤细胞和人外周血白细胞产生炎症性细胞因子的影响(Ⅰ)(英文)

目的:比较研究松杉灵芝水溶性多糖(Fl_0-b)及其甲酸修饰产物(FI_0-b-H)对人炎症性细胞因子产生的影响.方法:用放射免疫分析法(RIA)及逆转录聚合酶链反应(RT-PCR)分析法研究FI_0-b和Fl_0-b-H对人组织瘤细胞(THP-1)和人外周血单核细胞(PBMC)分泌的各种与炎症有关的细胞因子(白介素-1 α,6,8,肿瘤坏死因子α)及对白介素-1α,肿瘤坏死因子αmRNA表达的影响.结果:FI_0-b和FI_0-b-H(浓度分别为4,40,400 mg/L)显著抑制LPS 10 mg/L协同PMA 200 nmol/L诱导的THP-1细胞和PBMC细胞产生IL-1α和TNF α的量.当低浓度刺激剂(LPS 1mg/L协同PMA 200 nmol/L)刺激THP-1细胞时,FI_0-b-H明显提高白介素-8的产生;但当高浓度刺激剂(LPS 10 mg/L协同200 nmol/L PMA)刺激THP-1-细胞时,FI_0-b-H却明显抑制白介素-8的产生.FI_0-b-和FI_0-b-H对THP-1细胞白介素-1α和肿瘤坏死因子α的mRNA表达有显著作用.结论:与FI_0-b相比,FI_0-b-H在人炎症性细胞因子的产生方面表现出较强的活性.松杉灵芝菌丝体水溶性多糖在不同的刺激条件下,具有双向免疫调节作用,并具有一定的剂量依赖关系.     

冬凌草甲素通过激活caspase诱导HeLa细胞凋亡

目的　研究冬凌草甲素诱导人子宫颈癌HeLa细胞凋亡的作用机制。方法　采用形态学观察、DNA凝胶电泳及LDH法。结果　冬凌草甲素能显著诱导HeLa细胞发生凋亡 ,其作用呈明显的量效关系和时间依赖性。形态学观察可见凋亡小体的形成 ,琼脂糖凝胶电泳可见凋亡典型的DNA梯带 ;caspase家族抑制剂 ,caspase 1和 3抑制剂能抑制冬凌草甲素诱导HeLa细胞的凋亡 ,6 8 7μmol·L-1冬凌草甲素作用HeLa细胞 12h使caspase 3的活力提高 2倍。 结论　适宜浓度以下 ,冬凌草甲素 (6 8 7μmol·L-1)诱导HeLa细胞凋亡具有浓度与时间依赖性 ,大剂量 (137 4 μmol·L-1)时 ,冬凌草甲素诱导HeLa细胞坏死的程度强于凋亡 ,且通过激活caspase途径诱导HeLa细胞凋亡。     

Predictive Factors of Re-restenosis after Repeated Sirolimus-Eluting Stent Implantation for SES Restenosis and Clinical Outcomes after Percutaneous Coronary Intervention for SES Restenosis

Sirolimus-eluting stent (SES) is established to be effective in reducing restenosis. Repeat revascularization, however, is still required in up to 5–8% of patients. In this study, we analyzed clinical and angiographic variables that might be related with SES re-restenosis and variables related with re-restenosis after repeat SES implantation for SES restenosis. We also assessed clinical outcomes at 2-year follow-up after percutaneous coronary intervention (PCI) for SES restenosis. Repeat revascularization for SES restenosis was performed in 113 patients with 140 lesions. Of the 140 lesions, follow-up coronary angiography (CAG) was performed on 117 lesions (101 patients) and revealed 46 SES re-restenotic and 71 non-re-restenotic lesions. In multivariate analysis, SES-in-SES-strategy and reference diameter before the second PCI were independent predictors of re-restenosis after PCI for SES restenosis. However, the reference diameter was the only independent predictor of re-restenosis after SES-in-SES. Major adverse cardiac events (MACE) at 2 years were found in 44 patients (43.5%), and target lesion revascularization (TLR) was performed in 33.7% of patients after SES restenosis. In conclusion, the incidence of MACE and TLR was relatively high in patients with SES restenosis, but the placement of another SES on larger-diameter vessels may be an effective strategy for the second PCI .