MMP-2 and TIMP-2 are believed to contribute to the invasive properties of bladder carcinoma. The authors report that expression of MMP-2, TIMP-2, and MT1-MMP are useful prognostic indicators in patients with bladder carcinoma and may be helpful in designing treatment protocols.

with bladder carcinoma, the authors investigated the expression of MMP-2, TIMP-2, and MT1-MMP in patients with bladder carcinoma. METHODS. Tissues obtained from 41 patients with bladder carcinoma were usedDepartment of Urology, School of Medicine, The University of Tokushima, Tokushima, Japan.for analysis. Expression of MMP-2, TIMP-2, MT1-MMP, and glyceraldehyde-3-phosphate dehydrogenase was examined by reverse transcriptase-polymerase chain reaction analysis. Correlations between the levels of MMP-2, TIMP-2, and MT1-MMP expression and histologic findings or patient outcome were evaluated. RESULTS. Expression of MMP-2 and TIMP-2 was significantly higher in muscleinvasive pT2°bladder tumors than in pT1a tumors (MMP-2: P õ 0.0005; TIMP-2: P õ 0.005). Moreover, high levels of MMP-2 and TIMP-2, as well as MT1-MMP expression, all were strongly associated with decreased survival (MMP-2: P õ 0.0001; TIMP-2: P õ 0.0001; and MT1-MMP: P õ 0.005). Even within the radically cystectomized muscle invasive pT2°tumor group, patients with a high expression of any of these three genes had a worse prognosis than those with low expression (MMP-2: P õ 0.05; TIMP-2: P õ 0.05; and MT1-MMP: P Å 0.0641). such as colon and breast cancers. 7-11 However, tissue inhibitors of metalloproteinases (TIMPs) inhibit the activity of MMPs, and in- CONCLUSIONS. MMP-

Background: A unique case of metanephric adenoma of the left kidney is reported in a 61-year-old woman presenting with an incidental renal mass on ultrasonography. Methods/Results: On radiographic examination, the presence of hypovascular renal cell carcinoma was suspected and left radical nephrectomy was performed. The resected tumor, measuring 4.9 ¥ 4.7 ¥ 4.5 cm, was well-circumscribed and solid and its cut surface was tan-pink with foci of focal hemorrhage and cystic change. Microscopically, the tumor was composed of uniformly small acini with hyperchromatic round nuclei. Some acini were dilated and occasionally contained glomeruloid-like bodies and psamoma bodies.Immunohistochemically, tumor cells showed positive immunoreaction for vimentin, cytokeratin and Leu7. Cytogenetically, the tumor did not show numerical aberrations of chromosome 7 or 17 by fluorescence in situ hybridization. Conclusions:The patient is alive without recurrence or metastasis 4 years after surgery. Metanephric adenoma must be differentiated from other renal tumors, particularly Wilms' tumor or low-grade renal cell carcinoma. Immunohistochemical and cytogenetic analysis may be helpful in difficult cases.

The reactions of alkenes with peracetic acid in the presence of RuCls catalyst gave the corresponding -ketols, which are important building units for synthesis of biological active compounds, such as cortisone acetate.-Ketols are important synthetic intermediates and partial structures of various biologically active compounds such as cortisone acetate (l)1 and adriamycin acetate (2).* 12The methods for the synthesis of -ketols from enol ethers3 and enolates4 5have been studied extensively; however, those from olefins are limited to the oxidations with KMnOi-CuSOrSHzO6 7and with isobutylaldehyde/Oa in the presence of OSO4 and bis(3-methyl-2,4-pentanedionato)nickel(II) catalysts.6Recently, we found ruthenium-catalyzed oxidation of amines and amides with peroxides proceeds highly efficiently to give the corresponding -oxygenated products.7•8

Objective To investigate the role of tumour proliferation and p53 expression as a marker of survival in patients with urinary bladder cancer who undergo radical cystectomy. Patients and methods Samples were obtained from 31 patients (29 men and two women, mean age 66.0 years, range 46–80) with transitional cell carcinoma of the bladder who underwent radical cystectomy. The 31 formalin‐fixed radical cystectomy specimens were stained immunohistochemically for Ki‐67 antigen and p53 protein using MIB1 and p53 antibodies, respectively, and the results correlated with tumour grade, stages and prognosis. Results The Ki‐67 index was significantly greater in high‐grade tumours and in those overexpressing p53 (>20% positive nuclei). Patients whose tumour samples had a high Ki‐67 index (>32%) had a significantly worse prognosis than those with a lower index (P<0.01). There was a similar correlation between Ki‐67 index and prognosis in high‐risk patients (grade 3 and pT3–4; P<0.05). Although the associations between tumour grade, stage and p53 expression were not statistically significant, patients whose tumour samples overexpressed p53 had a lower survival rate (P<0.05). No patients with tumours having a low Ki‐67 and low p53 index (n=14) died of urinary bladder cancer during the follow‐up. Conclusion These results suggest that immunohistochemical analyses for Ki‐67 and p53 are useful prognostic indicators in patients with urinary bladder cancer who undergo radical cystectomy; the prognostic role of these markers was particularly important in high‐risk (grade 3 and pT3–4) patients.