Jean-Louis Pariente

Analytical and prospective evaluation of urinary cytokeratin 19 fragment in bladder cancer

PURPOSE We evaluated CYFRA 21-1, an immunoradiometric assay, developed to detect soluble cytokaratin 19 fragment, for its diagnostic performance in bladder transitional cell carcinoma as well as its analytical performance. MATERIALS AND METHODS We assessed CYFRA 21-1 in the serum and urine of 182 patients, including 66 with bladder transitional cell carcinoma (group 1), 66 with another urological pathology (group 2) and 50 free of urothelial disease (group 3). The power of urinary CYFRA as a diagnostic test for bladder transitional cell carcinoma was evaluated by receiver operating characteristics curve analysis. Analytical performance was assessed by determining intra-assay and interassay precision, and accuracy by dilution testing and recovery of supplemented analyte. RESULTS Mean urinary CYFRA plus or minus standard deviation was 154.39+/-49.00, 22.6+/-8.9 and 2.40+/-0.14 ng./ml. in groups 1 to 3, respectively (significantly different). Receiver operating characteristics curve analysis revealed optimal 96.9% sensitivity and 67.2% specificity for a threshold value of 4 ng./ml. Analytical determination showed that intra-assay and interassay precision provides a satisfactory coefficient of variation. The assay for accuracy had acceptable recovery in diluted samples as well as in those with supplemented analyte. CONCLUSIONS The urinary immunoradiometric CYFRA 21-1 assay performs well analytically. Urinary CYFRA 21-1 is a useful marker for diagnosing transitional cell carcinoma and provides sensitivity in low grade disease.

In vitro cytocompatibility of radio-opacifiers used in ureteral endoprosthesis

Ureteral endoprostheses are urinary catheters made of polymeric biomaterials made radio-opaque through the addition of X-ray absorbing additives such as barium, bismuth, tantale or tungsten. The aim of this work was to study the in vitro toxicity of solutions of these radio-opacifiers using two cell culture models. Primary-cultures of human urothelial cells (HUC) arising from normal adult urinary tract and permanent urothelial cell line were used. Solutions at different dilutions were placed into the wells containing monolayers of confluent cells. After 24 h incubation period, the solutions were removed and cell viability and cell metabolic activity tests were performed (Neutral Red assay and MTT assay). At a concentration lower than 1 mg l(-1) the different radio-opacifiers used showed no toxicity. From 1 to 3 mg l(-1) one can note a significant dose-dependent decrease of cell metabolic activity of solely HUC for barium chloride. At 3 mg l(-1) one can note a significant deleterious effect on HUC metabolic activity, with bismuth and tantale. For tungsten, there is no deleterious effect, but on the contrary a significant increase in HUC metabolic activity at a 0.5 mg l(-1) concentration. None of the solutions did provoke alterations in HUC viability for concentrations less than 3 mg l(-1). Interestingly, for permanent cell line one can note a solely significant decrease of cell viability at 3 mg l(-1) for tantale. All the other tested salts on permanent cell line were not significantly different from controls for cell viability as well as cell metabolic activity. HUC culture model may be of relevance for the screening of radio-opacifiers intended for ureteral endoprostheses.

First use of cultured human urothelial cells for biocompatibility assessment: Application to urinary catheters

For several years, studies performed to estimate in vitro biocompatibility of urinary catheters have been carried out using permanent cell lines. But for a rational design of the testing procedure, the cell culture model should relate to the material application. This work presents the results of a probe study designed to obtain an in vitro model of normal human urothelial cells (HUC) and to test the relevance of this system in cytocompatibility experiments of urinary catheters currently used.A comparison is made with continuous cell lines, the use of which is recommended by normalization bodies. We exposed monolayers of HUC (well characterized for their proliferation, qualitative evaluation, and quantitative measurement of cytokeratins) and two continuous human cell lines to liquid extracts (either pure or diluted in the culture medium) of nine available catheters, including positive (latex) and negative controls, for a 24 h incubation. Then colorimetric assays (Neutral Red and MTT) were performed. The extracts of two polyurethanes provoked a significant toxic effect on HUC only, suggesting differences in sensitivity between the models used. This effect could be due to the presence of a great amount of barium (used as a radioopacifier) in extracts, as highlighted by results of absorption emission spectroscopy. A culture model of HUC may be of relevance for the screening of materials intended for urological practice.

An in vitro biocompatibility evaluation of double-J stents

OBJECTIVES For several years, studies performed to estimate in vitro biocompatibility of urinary catheters have been carried out using permanent cell lines. However, for a rational design of the testing procedure, the cell culture model should depend on the material application. We assess the biocompatibility of 13 double-J stents using an in vitro model of normal human urothelial cells (HUC). This article aims to mimic in vitro, on HUC monolayers, the close contact existing in vivo between the urothelium and double-J stents and to evaluate the subsequent effect on these cells. METHODS Fragments of each stent were deposited into the wells containing confluent HUC, with close contact maintained between the material and the cells. The same procedure with either no material or fragments of latex catheter was undertaken to provide the negative and positive controls, respectively. The contact was maintained for 1, 3, and 8 days. At the end of the incubation period, fragments of stent were removed and cell activity tests were performed (neutral red assay, MTT assay, and cell proliferation). RESULTS One of the silicone stents is significantly deleterious on HUC as determined by three tests after 8 days of contact. For two copolymers, a tendency to increase cell proliferation was noted. Concerning polyurethanes, we observed significant decreases in HUC viability and cell metabolic activity for five stents after 8 days of contact. All seven polyurethane stents significantly inhibited cell proliferation. CONCLUSIONS The HUC culture model may be of relevance for the screening of materials intended for use as double-J stents.

Fertilité masculine après chimiothérapie: à propos d’une série de 26 patients traités pour cancer du testicule stade 1

ResumeLes paternités de 26 patients traités par chimiothérapie pour un cancer du testicule ont été recensées par une enquête téléphonique. Ces patients étaient atteints du même type histologique de cancer, au même stade, et ils ont tous bénéficié du même protocole chimiothérapique.Parmi les 26 patients suivis, 7 désiraient des enfants après leur maladie. Cinq couples seulement ont eu satisfaction avec un délai de survenue de grossesse de 2 ou 3 ans. Deux couples qui avaient fait preuve de leur paternité avant la maladie n’ont pas encore eu satisfaction (recul de 4 et 3 ans).Quatorze patients parmi les 26 inclus dans cette étude ont eu recours à l’auto-conservation de sperme et un seul d’entre eux a utilisé ses paillettes.Le cancer du testicule peut entraîner des troubles de la spermatogenèse avant même qu’un traitement chimiothérapique soit mis en place. La chimiothérapie peut ensuite entraîner des lésions plus ou moins réversibles qui vont être fonction des molécules et des doses de produits utilisés.Les méthodes de protection de la spermatogenèse étant pour l’instant peu efficaces chez l’homme, la conservation du sperme est le seul moyen d’assurer au patient sa fertilité ultérieure.AbstractA phone inquiry identified paternity among 26 patients treated for testis cancer through chemotherapy. The patients suffered from the same histological type of cancer at the same stage of development and all received the same chemotherapy. Among the 26 patients examined, seven of them wished to have children after the disease. Only five couples saw their wish fulfilled with a pregnancy occuring within 2 or 3 years at time. Two couples who had parented before the disease have not yet had satisfaction (after 4 and 3 years).14 out of the 26 patients considered in the study have resorted to preservation of their semen and only one of them used.Testicular cancer can cause spermatogenesis dysfonction even before chemotherapy has started. Chemotherapy agents can then cause lesions which can be of a variable degree of reversibility depending on the molecules and the doses used in the products.Ways of protecting spermatogenesis in man being as yet of very limited efficiency, preserving semen is the only way of assuring future fertility in the male patients.

Ileocolonic Anastomosis by Biofragmentable Ring for Bladder Substitution

Since the nineteenth century many concepts for anastomosis have been described. In 1892, Murphy performed a ring anastomosis using a steel button. This technique is now used with a biofragmentable ring made of polyglycolic acid (87.5% by weight) and barium sulfate (12.5% by weight). The ring breaks into fragments by hydrolysis in 15–23 days. The differents fragments are eliminated in the stool. The barium sulfate makes X-ray control easy