Antibodies to cultured tumor cells detected in sera of renal cell carcinoma patients by a quantitative avidin-biotin method

Antibodies reacting with the tumor cell line RC-Pa were measured by a quantitative avidin-biotin complex method. Sera of renal cell carcinoma patients, patients with other types of cancer and healthy donors were analyzed. Of 71 sera from renal cell carcinoma patients 67 (94 per cent) were classified as showing renal cell carcinoma, while 32 of 36 sera (89 per cent) from healthy subjects were classified as showing no renal cell carcinoma. Four of 21 serum specimens (19 per cent) from individuals with other than renal cancer were misclassified. Furthermore, sera from renal carcinoma patients immunized with a mixture of autologous tumor cells and Corynebacterium parvum showed a marked increase in reactivity compared to those from patients receiving progesterone. The results indicate that this assay might become useful to detect or monitor renal cell carcinoma.     

Demonstration of specific antibodies against diethylstilbestrol during treatment of prostatic cancer

Antibodies against diethylstilboestrol were detected in prostatic cancer patients treated with diethylstilboestrol (DES). Direct radioimmunoassay (DRIA) was performed in 109 patients divided into three groups: a control group of 33 patients (group I), a group of 38 patients treated by DES and free of cardiovascular complications (group II), and a group of 38 patients treated by DES with cardiovascular complications (group III). Antibody count was significantly higher in group III than in the two other groups (p less than 0.05). These results suggest that DES antibodies may play a role in estrogen-associated cardiovascular toxicity. For this reason, DES should not be used in patients with a positive assay.     

Epidermal growth factor receptor regulates normal urothelial regeneration

Members of the epidermal growth factor (EGF) family and their receptors are involved in many cellular processes, including proliferation, migration, and differentiation. We have previously reported that these growth factors are expressed and have specific regulatory functions in an organ-like culture model of normal human urothelial cells. Here, we used this model to investigate the involvement of EGF receptor (EGFR) in human urothelial regeneration. Three 4-mm-diameter damaged areas were made in confluent normal human urothelial cell cultures with a biopsy punch. Regeneration was measured, on fixed stained cultures, with an image analyzer, at 4, 24, and 48 hours after injury. Cell proliferation was assessed by 5-bromo-2-deoxyuridine incorporation. To identify EGF family factors potentially involved in the healing process, we studied the effect of these factors on damaged confluent cultures and the level of expression of mRNAs extracted from these cultures. EGFR inhibition of the proliferation and migration of urothelial cells was tested with (1). a specific tyrosine kinase inhibitor (AG1478) and (2). a blocking anti-EGFR antibody (LA22). Exogenously added amphiregulin, EGF, transforming growth factor-alpha and heparin-binding EGF (HB-EGF) stimulated urothelial regeneration. The damaged areas were repaired by regrowth within 48 hours. Both AG1478 and LA22 inhibited the repair (by 50% and 30%, respectively), as well as proliferation and migration. This regeneration was accompanied by increased HB-EGF mRNA expression in cultures of cells from four of six subjects, but no corresponding change in EGFR protein level was observed. These results indicate that the EGFR signaling pathway is involved in urothelial regeneration. Our data support an autocrine role of HB-EGF in this process and suggest that the EGFR pathway is a potential therapeutic target for modulating urothelial cell proliferation.     

Recognition of an extensive range of IgE-reactive proteins in cod extract

Allergy to fish is one of the most common food allergies. Gad c 1 is the only fish allergen which has been purified and characterized. Other allergens have been detected by Western blot in cod extracts. We have now improved the Western-blot procedure in order to characterize fish IgE-reactive proteins from extracts prepared under different conditions: pre-rigor mortis and postrigor mortis. EDTA addition or not. and DEAE ion-exchange chromatography. Several IgE-reactive protein bands have been identified over a wide molecular-weight range. In particular, the 104- and 130-kDa IgEreactive protein bands were detected. These new bands may correspond to aggregates, as EDTA increased the relative amount of the 60-, 67-, 104-, and 130-kDa IgE-reactive protein bands in Western blot. All these bands were also detected by an antiparvalbumin monoclonal antibody, specific to the first calcium-binding site. The longer period of storage increased the relative amounts of the 41-, 80-, 104-. and 130-kDa IgE-reactive protein bands. The 18-kDa band was detected only in fish stored for several days. In conclusion, we have described IgE-reactive protein bands over a wide molecular-weight range (12–130 kDa) in Western blot of cod extract, and shown that EDTA and storage conditions may influence the relative distribution of IgE-reactive protein bands.     

Detection of the apoptosis-suppressing oncoprotein bc1-2 in hormone-refractory human prostate cancers.

The oncoprotein encoded by bc1-2 is unique because of its intracellular location (a mitochondrial membrane protein) and apparent mode of action (suppression of apoptosis). To date, this oncogene has been associated only with the development of certain forms of human B-cell lymphoma. In this report, we describe our experience with a monoclonal antibody made against a synthetic peptide for bc1-2 that can recognize the bc1-2 protein and identify cells in human prostate glands expressing this proto-oncogene with in situ immunohistochemical procedures. These procedures were utilized to survey a series of 62 human tissues to evaluate whether bc1-2 might have a role in the developing prostate gland or in prostate oncogenesis. While all primordial epithelial cells in a fetal prostate gland immunostain for bc1-2, normal and hypertrophic prostate glands of the adult show bc1-2 expression restricted to the basal cells. All epithelial cells in areas of prostatic intraepithelial neoplasia were stained by this antibody, as were most (62%) localized invasive prostatic carcinomas. In contrast, all primary prostatic carcinomas and metastases obtained from metastatic prostate cancer patients after hormone treatment (hormone-refractory tumors) stained positive for bc1-2. This study demonstrates that the oncoprotein encoded by bc1-2 can be detected at sequential stages in the natural history of human prostate cancer. Since the bc1-2 oncoprotein is known to suppress the cellular response to apoptotic stimuli, it will be important to determine whether bc1-2 expression is a factor in the development of prostate cancers and in the survival of hormone-refractory prostate cancer cells.     

Transcription Factor PU.1 Promotes Conventional Dendritic Cell Identity and Function via Induction of Transcriptional Regulator DC-SCRIPT

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Results of pyeloureterostomy after ureterovesical anastomosis complications in renal transplantation

OBJECTIVES: The most frequent urologic complications after renal transplantation involve the ureterovesical anastomosis (ie, leakage, stenosis, and reflux), with a frequency of 1% to 30% in different series. We present the results of pyeloureterostomy using the recipient's ureter. METHODS: From 1988 to 1996, 570 cadaveric renal grafts were performed at our institution. A Lich Gregoir ureterovesical anastomosis was used in every case. Complications involving the anastomosis occurred in 19 cases (3.3%), with 10 stenoses (1.7%), 6 cases of leakage (1.1%), and 3 of reflux (0.5%). The mean donor age was 36.2 years, and the mean duration of cold ischemia was 29.4 hours. The mean recipient age was 41.3 years. Corrective surgery was performed 0.09 years (range 0.01 to 0.22) after transplantation for leakage, 1.13 years (range 0.14 to 5.11) for stenosis, and 5.55 years (range 0.51 to 9.71) for reflux. The recipient's ureter was stented with a ureteral catheter before median laparotomy, except in 3 cases of early leakage (less than 3 days). The recipient's ureter was cut, without the need for ipsilateral nephrectomy, and sutured to the graft pelvis. A nephroureterostomia stent (Gil Vernet stent) (12 cases) or a double J ureteral stent (7 cases) was used for urinary drainage. RESULTS: One graft was lost on day 1 through renal vein thrombosis. Percutaneous nephrostomy was performed on day 2 to clear an obstruction of the double J ureteral stent in one case, and a double J ureteral stent was inserted on day 2 because the nephrouretrostomia stent was incorrectly positioned in another case. Pyelographic controls on day 15 were normal in every case. The mean follow-up was 2.25 years (range 0.24 to 6.1) (2.9 years for leakage, 2.08 years for stenosis, and 1.44 years for reflux). One patient died with a functional graft 3 years after surgery. One graft was lost 4 years after surgery through chronic rejection. There were no complications affecting the ipsilateral kidney. No further ureteral complications occurred after surgery. The mean creatinine level 3 years after surgery was 1.59 mg/dL. CONCLUSIONS: Pyeloureterostomy is a safe and permanent treatment for complications of ureterovesical anastomosis and gives excellent results. The technique requires stenting of the recipient's ureter and graft drainage with a nephroureterostomia stent or a double J ureteral stent.     

Retroperitoneoscopy: A laparoscopic approach for adrenal and renal surgery

Objectives

Retroperitoneoscopy has gained acceptance for urologic surgery. We assessed the safety and efficacy of this procedure for renal and adrenal surgery.

Methods

Since December 1994, 20 patients (18 to 75 years old) have undergone laparoscopic adrenalectomy and nephrectomy, including simple nephrectomy in 8, partial nephrectomy in 1, radical nephrectomy in 2, tumorectomy with cyst excision in 1, and adrenalectomy in 8. The retroperitoneal space was created by blunt dissection with the index finger, completed by insufflation, without balloon dissection.

Results

Average kidney size was 65 mm (range 50 to 108), and average adrenal tumor size was 31 mm (range 20 to 40). The average operating time was 127 minutes (range 60 to 180) for nephrectomy and 84 minutes (range 45 to 140) for adrenalectomy. The average hospital stay was 3 days (range 1 to 7) for nephrectomy and 2.4 days (range 1 to 4) for adrenalectomy. Average blood loss was 65 mL for both nephrectomy and adrenalectomy. Conversion from the laparoscopic procedure to open surgery was never required. Peritoneal effraction and ureteral injury occurred in only 4 patients and 1 patient, respectively.

Conclusions

The laparoscopic retroperitoneal approach is safe and effective for simple renal nephrectomy and for excision of small adrenal tumors. Perioperative morbidity and hospital stay are reduced.