Jorge Antonio Pastro Noronha

Validation of PI-RADS v.2 for prostate cancer diagnosis with MRI at 3T using an external phased-array coil.

To date, few studies have validated the Prostate Imaging Reporting and Data System Version 2 (PI‐RADS v. 2) for the diagnosis of prostate cancer. Our aim was to validate PI‐RADS v.2 using 3 Tesla (T) MRI.

Is there an association between T102C polymorphism of the serotonin receptor 2A gene and urinary incontinence

The regulation of bladder function is influenced by central serotonergic modulation. Several genetic polymorphisms related to serotonin control have been described in the literature. T102C polymorphism of the serotonin receptor 2A gene (5-HT2A) has been shown to be associated with certain diseases such as non-fatal acute myocardial infarction, essential hypertension, and alcoholism. In the present study, we examined the association between 5-HT2A gene polymorphism and urinary incontinence in the elderly. A case-control study was performed in 298 elderly community dwellers enrolled in the Gravataí-GENESIS Project, Brazil, which studies gene-environmental interactions in aging and age-related diseases. Clinical, physical, biochemical, and molecular analyses were performed on volunteers. 5-HT2A genotyping was determined by PCR-RFLP techniques using the HpaII restriction enzyme. The subjects had a mean age of 68.05 +/- 6.35 years (60-100 years), with 16.9% males and 83.1% females. The C allele frequency was 0.494 and the T allele frequency was 0.506. The CC genotype frequency was 21.78%, the CT genotype frequency was 55.24% and the TT genotype frequency was 22.98%. We found an independent significant association between the TT genotype (35.7%) and urinary incontinence (OR = 2.06, 95%CI = 1.16-3.65). Additionally, urinary incontinence was associated with functional dependence and systolic hypertension. The results suggest a possible genetic influence on urinary incontinence involving the serotonergic pathway. Further investigations including urodynamic evaluation will be performed to better explain our findings.

Spontaneous urinary voiding of a metallic implant after operative fixation of the pubic symphysis: a case report.

isplaced fractures and dislocations of the pelvic ring and acetabulum are usually treated with open reduction and internal fixation with a plate and screws. Loosening and migration of these plates can occur; however, to the best of our knowledge, we are the first to describe the migration of such implants into the urinary tract through the bladder wall. We report the case of a patient who experienced late migration of a screw and washer into the bladder with spontaneous voiding of the screw. Case Report n September 1992, a twenty-five-year-old man was brought to the emergency room of the Hospital São Lucas, Pontificia Universidade Católica do Rio Grande do Sul—PUCRS, in Porto Alegre, Brazil, after being run over by an automobile. The patient underwent exploratory laparotomy for a hemoperitoneum, and a splenectomy was performed. No evidence of bladder injury was noted. Skeletal traction was applied to the right lower extremity because of a transverse fracture of D I

Increased tissue factor expression is an independent predictor of mortality in clear cell carcinoma of the kidney.

PURPOSE Increased expression of tissue factor (TF), a primary initiator of the extrinsic coagulation pathway, has been associated with a worse prognosis in a variety of solid tumors. We report for the first time the correlation of the immunohistochemical expression of tissue factor with clinical and pathological outcomes in clear cell carcinomas of the kidney. MATERIALS AND METHODS immunohistochemical expression of tissue factor was evaluated in 58 paraffin-embedded samples of clear cell carcinomas of the kidney treated at the same university hospital, that was correlated with clinical and pathological variables and with overall survival. RESULTS high intensity tissue factor expression (TF area > 10 µ m2) was observed in 22.4% of the tumors (13 patients), and was an important predictor of overall mortality, both in univariate and multivariate analysis (p < 0.05). Median overall survival for both groups was 66 months; 78.2 months for patients in the group of lower TF expression and 27.5 months for patients in the group of higher TF expression (log rank p < 0.001). The hazard ratio for mortality was 9.7 (CI 3.7-25.6) for tumors with increased TF expression. CONCLUSIONS Increased immunohistochemical expression of TF was an important independent predictor of mortality in a contemporary cohort of patients with clear cell carcinoma of the kidney. Further studies are necessary to define the role of TF in clinical practice.

MP39-16 SERUM TISSUE FACTOR AS A BIOMARKER FOR RENAL CLEAR CELL CARCINOMA

patients were stained for iron and TfR1 protein using Prussian Blue and immunohistochemistry, respectively. 178 tissue cores from 14 different body sites of non-cancer patients were included as controls. Staining was scored by a clinically blinded genitourinary pathologist based on the product of intensity and tissue percentage (Z-score), and tested for association with clinicopathologic features and survival using a MannWhitney U test, Kruskal Wallis test and Cox regression model. RESULTS: Renal epithelium from non-cancer patients had low iron content (mean Z-score,MZS1⁄4 0.1), but by far the highest TfR1 levels of any tissue site in the body (MZS1⁄4 153). Compared to non-cancer patients, iron content in RCC patients increased mildly (4-fold) in benign renal epithelium (MZS1⁄4 0.6) and dramatically (>100 fold) in primary tumors (MZS1⁄4 21, p< 0.001). Higher tumor iron content was accompanied by moderate TfR1 downregulation (MZS1⁄4 21, p< 0.001) and associated with clear cell and papillary histologies, male gender and tobacco usage (p< 0.05 each). Opposite to changes observed with tumorigenesis, iron and TfR1 levels decreased and increased, respectively, with progression in tumor size, grade, pT stage andmetastatic stage (all p< 0.05). Iron loss andTfR1upregulationweremost apparent inmetastatic lesions (MZS1⁄45 and 111, respectively) and each associated with patient anemia and worse RCC-specific survival (all p< 0.05). CONCLUSIONS: Benign renal epithelium has uniquely high levels of the iron import protein, TfR1, potentially priming these cells for dysregulated iron uptake and large intracellular iron increases (>100 fold) during tumorigenesis. Reduction in iron content during RCC progression to metastasis, despite TfR1 increases, may reflect lower systemically available iron in advanced RCC patients and raises the possibility that these cancers might have increased susceptibility to iron deprivation as a novel therapeutic strategy.