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[...]the question arises as to why is there a disparity between theory and real practice? [...]in many European countries, this has led to concept of office urologists, and data show that as many as 70% of urologists in France and Germany, 40% in Austria, and 33% in Greece are office urologists. According to the 2011 census, there are 4041 statutory towns in India.

Penile Carcinoma In a large series involving 89 men with invasive penile squamous cell carcinoma (SCC) without palpable inguinal disease, Ramos et al. have reported the diagnostic precision of sentinel lymph node biopsy (SLNB). For the entire cohort, the authors have reported that dynamic SLNB had a sensitivity of 84%, a specificity of 89%, and a false-negative rate of 6.6%, with a similarity ratio (LR+) of 7.80 (3.80–16.03) and a likelihood ratio (LR−) of 0.18 (0.07–0.44). [...]when the authors have calculated the sensitivity and specificity only for high-risk T1 patients, who required superficial inguinal lymphadenectomy according to the current NCCN guidelines, the sensitivity was 33% and the specificity 100% for such subgroup of patients, along with a positive predictive value of 100%, a negative predictive value of 93%, and a diagnostic accuracy of 93.9%.

Mutation or overexpression renders pan-RAS (rat sarcoma) proteins insensitive to inactivation. Activated pan-RAS communicates signal from the cell surface receptor to activate RAS-MAPK/ERK (RAS-mitogen-activated protein kinases/extracellular signal regulated kinases) signaling and orchestrates epithelial-to-mesenchymal transition-activating transcription factors (EMT-ATFs) reprogramming to induce EMT. Owing to limited studies available in bladder cancer, the present study is taken up to examine the expressions of the EMT-associated markers in pan-RAS-pERK1/2 (pan-RAS-phosphoERK1/2)-positive well-characterized cohort of forty-two non-muscle invasive bladder cancer (NMIBC) and forty-five muscle invasive bladder cancer (MIBC) patients. Immunohistochemical staining was performed on paraffin embedded tissue sections to determine the immunolevels and cellular localization of marker proteins. Semi-quantitative expressions of pan-RAS, pERK1/2, and EMT markers (E-cadherin, Vimentin, N-cadherin, Snail, Slug Twist, and Zeb1) were statistically examined with clinicohistopathological profile of the patients using SPSS, version 20.0 software. The study documents the diagnostic relevance of immunohistochemical expressions of pan-RAS-pERK1/2/EMT-associated markers in order to stratify NMIBC and MIBC patients. Follow-up studies supported the role of altered EMT phenotype in pan-RAS-pERK1/2-activated positive tumors with disease aggressiveness. To the best of our knowledge, our study is the first concluding the impact of altered EMT phenotype via pan-RAS-pERK1/2 axis on the short survival outcome [short overall survival (OS) ( p  = 0.04), short progression-free survival (PFS) ( p  = 0.02) and short cancer-specific survival (CSS) ( p  = 0.03)] of muscle invasive bladder cancer patients.

[5] The author has rightly emphasized the role of institutions in maintaining databases that can be used by residents for research purposes. [...]the most important determinant is \"student characteristics.\" Is povidone iodine an alternative to silver nitrate for renal pelvic instillation sclerotherapy in chyluria? BJU Int 2004;94:1082-5.

Overexpression of normal Ras and its aberrant CpG island methylation in the promoter regions have been shown to direct cells for uncontrolled abnormal growth and bladder tumor formation and therefore, fetched recent attention as a marker of diagnosis and prognosis to predict the biological behavior of urothelial carcinoma of bladder (UCB). Methylation pattern at CpG islands of the promoter regions of rat sarcoma (Ras) gene homologues namely Kristen-Ras (K-Ras), Harvey (H-Ras), and Neuroblastoma (N-Ras) were examined by methylation specific polymerase chain reaction (MSP). Real time-quantitative polymerase chain reaction (RT-qPCR) was done to determine transcriptomic expressions of these Ras isoforms in the prospective series of 42 NMIBC (non-muscle invasive bladder cancer) and 45 MIBC (muscle invasive bladder cancer) biopsies. CpG loci in H-Ras and K-Ras were observed to be more hypomethylated in MIBC, whereas more hypomethylation in N-Ras was noted in NMIBC. Strong association of hypomethylation index with tumor stage, grade, type and size validate them it as marker of diagnosis in UCB patients. Differential overexpression of H-Ras, N-Ras and K-Ras genes in NMIBC and MIBC and their association with patients’ demographics identify them as important diagnostic markers in pathogenesis of UCB. Given the reported ability of promoter hypomethylation to activate Ras expression, correlation studies examined positive significant association between hypomethylation index and expression. Study concludes that promoter hypomethylation of N-Ras and K-Ras could be a potential confounder of their increased expression in NMIBC. Biological significance of simultaneous presence of higher expression and promoter hypomethylation of Ras gene isoforms in MIBC is difficult to resolve in a given cohort of patients.