http://matera.fimmg.org/Linee%20guida/Linee%20guida%20nella%20nefrolitiasi%20(ing).pdf

Guidelines on urolithiasis

Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline

Incidence and treatment of complications of bacillus Calmette-Guerin intravesical therapy in superficial bladder cancer.

Bacillus Calmette-Guerin (BCG) has been used to treat non-muscle-invasive bladder cancer for more than 30 years. It is one of the most successful biotherapies for cancer in use. Despite long clinical experience with BCG, the mechanism of its therapeutic effect is still under investigation. Available evidence suggests that urothelial cells (including bladder cancer cells themselves) and cells of the immune system both have crucial roles in the therapeutic antitumour effect of BCG. The possible involvement of bladder cancer cells includes attachment and internalization of BCG, secretion of cytokines and chemokines, and presentation of BCG and/or cancer cell antigens to cells of the immune system. Immune system cell subsets that have potential roles in BCG therapy include CD4(+) and CD8(+) lymphocytes, natural killer cells, granulocytes, macrophages, and dendritic cells. Bladder cancer cells are killed through direct cytotoxicity by these cells, by secretion of soluble factors such as TRAIL (tumour necrosis factor-related apoptosis-inducing ligand), and, to some degree, by the direct action of BCG. Several gaps still exist in our knowledge that should be addressed in future efforts to understand this biotherapy of cancer.

The mechanism of action of BCG therapy for bladder cancer—a current perspective

The management of renal angiomyolipoma.

Intravesical Bacillus Calmette-Guerin Therapy for Superficial Bladder Cancer: Effect of Bacillus Calmette-Guerin Viability on Treatment Results

The effect of intravesical Bacillus Calmette-Guerin (BCG; Pasteur strain) treatment on the frequency of implantation and growth rate of the murine transitional cell carcinoma of the bladder, MBT-2, was studied. MBT-2 cells were instilled into the bladder immediately after electrocauterization, and BCG instillations (40, 80, and 160 micrograms/instillation) were initiated 24 hr later and continued on a weekly basis for 4 weeks. BCG treatment significantly (p less than 0.0002) reduced the incidence of tumor implantation in a dose-dependent manner and resulted in significantly (p less than 0.0001) smaller tumors when they appeared in BCG-treated mice. The therapeutic effect of BCG correlated with augmentation of natural killer cell (NK) activity and positive purified protein derivative (PPD) footpad reactions. In experiments in which treatment was initiated with rapidly growing BCG organisms (10(7) colony-forming units/mg), tumor implantation was inhibited, there was a dose-dependent increase in NK activity, and mice had positive footpad reactions in PPD. In experiments in which BCG with reduced viability (10(6) colony-forming units/mg) and slower growth rates was used for treatment, no significant inhibition of tumor implantation was observed, NK activity was depressed, and PPD footpad tests were uniformly negative. The results suggest that the therapeutic effects of BCG therapy in this murine model correlate with augmentation of NK activity and positive footpad reactions to PPD and further suggest that the viability and growth rate of BCG organisms are important factors in determining the efficacy of intravesical BCG therapy.

https://cancerres.aacrjournals.org/content/canres/43/4/1611.full.pdf

Reduction of Bladder Tumor Growth in Mice Treated with Intravesical Bacillus Calmette-Guérin and Its Correlation with Bacillus Calmette-Guérin Viability and Natural Killer Cell Activity

Diagnosis and management of renal angiomyolipoma

Four methods of intravesical implantation of the transplantable mouse bladder tumor, MBT-2, and their effects on intravesical therapy with Bacillus Calmette-Guerin (BCG) were compared, and modifications which improved implantation are described. Pretreatment of the bladder with N-methyl-N-nitrosourea (MNU) resulted in tumor implantation in approximately two-thirds of the animals; however, all tumors penetrated the bladder wall. Using the MNU implantation procedure, intravesical BCG therapy was shown to reduce MBT-2 outgrowth by 77%. Tumor cell instillation after electrocautery produced an incidence of tumor implantation similar to that of the MNU procedure. The efficacy of BCG for the electrocautery implantation procedure also was similar to the MNU method. With the electrocautery procedure, the electrode and tumor cells were introduced into the bladder via a catheter prepared from PE 10 polyethylene tubing. The procedure required two catheterizations and produced a 24% incidence of extravesical tumors. Use of a Teflon catheter and a single catheterization for tumor cell instillation resulted in a reproducible method for implanting MBT-2 tumors which were all confined within the bladder. The efficacy of BCG therapy was unchanged from that described for the other implantation techniques.

/pdf/technical-factors-affecting-the-reproducibility-of-1v2mepmbpy.pdf

Amos Shapiro

Papers

Intravesical Bacillus Calmette-Guerin Therapy for Superficial Bladder Cancer: Effect of Bacillus Calmette-Guerin Viability on Treatment Results

Reduction of Bladder Tumor Growth in Mice Treated with Intravesical Bacillus Calmette-Guérin and Its Correlation with Bacillus Calmette-Guérin Viability and Natural Killer Cell Activity

Diagnosis and management of renal angiomyolipoma

Technical Factors Affecting the Reproducibility of Intravesical Mouse Bladder Tumor Implantation during Therapy with Bacillus Calmette-Guérin

Segmental testicular infarction due to sickle cell disease.