Prostate

Comparative reviews of whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography/computed tomography (CT; with different radiotracers) have shown that metastasis detection in advanced cancers is more accurate than with currently used CT and bone scans. However, the ability of WB-MRI and positron emission tomography/CT to assess therapeutic benefits has not been comprehensively evaluated. There is also considerable variability in the availability and quality of WB-MRI, which is an impediment to clinical development. Expert recommendations for standardising WB-MRI scans are needed, in order to assess its performance in advanced prostate cancer (APC) clinical trials. To design recommendations that promote standardisation and diminish variations in the acquisition, interpretation, and reporting of WB-MRI scans for use in APC. An international expert panel of oncologic imagers and oncologists with clinical and research interests in APC management assessed biomarker ...

The aim of this study was to assess the feasibility of diffusion tensor imaging (DTI) of the prostate and to determine normative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of healthy prostate with a 3-Tesla magnetic resonance imaging (MRI) system. Thirty volunteers with a mean age of 28 (25–35) years were scanned with a 3-Tesla MRI (Intera Achieva; Philips, The Netherlands) system using a six-channel phased array coil. Initially, T2-weighted turbo spin-echo (TSE) axial images of the prostate were obtained. In two subjects, a millimetric hypointense signal change was detected in the peripheral zones on T2-weighted TSE images. These two subjects were excluded from the study. DTI with single-shot echo-planar imaging (ssEPI) was performed in the remaining 28 subjects. ADC and FA values were measured using the manufacturer supplied software by positioning 9-pixel ROIs on each zone. Differences between parameters of the central and peripheral zones were assessed. Mean ADC value of the central (1.220 ± 0.271 × 10−3 mm2/s) was found to be significantly lower when compared with the peripheral gland (1.610 ± 0.347 × 10−3 mm2/s) (P < 0.01). Mean FA of the central gland was significantly higher (0.26), compared with the peripheral gland (0.16) (P < 0.01). This study shows the feasibility of prostate DTI with a 3-Tesla MR system and the normative FA and ADC values of peripheral and central zones of the normal prostate. The results are compatible with the microstructural organization of the gland.

BACKGROUNDProstate cancer (PCa) is the second leading cause of cancer-related death in men in the United States. Many men have implemented purported chemopreventive agents into their daily diet in an attempt to delay the early onset of a PCa. Green tea polyphenols, one such agent, has been shown to be chemopreventive in skin, breast, and prostate cancers. We hypothesized that Epigallocatechin-3-Gallate (EGCG), the major polyphenol found in green tea, will exert its chemopreventive effect in the prostate via regulation of sex steroid receptor, growth factor-signaling, and inflammatory pathways.Prostate cancer (PCa) is the second leading cause of cancer-related death in men in the United States. Many men have implemented purported chemopreventive agents into their daily diet in an attempt to delay the early onset of a PCa. Green tea polyphenols, one such agent, has been shown to be chemopreventive in skin, breast, and prostate cancers. We hypothesized that Epigallocatechin-3-Gallate (EGCG), the major polyphenol found in green tea, will exert its chemopreventive effect in the prostate via regulation of sex steroid receptor, growth factor-signaling, and inflammatory pathways.METHODSFive-week-old male TRAMP (Transgenic Adenocarcinoma Mouse Prostate) offspring were fed AIN-76A diet and 0.06% EGCG in tap water. Animals were sacrificed at 28 weeks of age and the entire prostates were scored histopathologically. In addition, animals were sacrificed at 12 weeks of age and ventral (VP) and dorsolateral (DLP) prostates were removed for histopathological evaluation and immunoblot analyses or ELISA.Five-week-old male TRAMP (Transgenic Adenocarcinoma Mouse Prostate) offspring were fed AIN-76A diet and 0.06% EGCG in tap water. Animals were sacrificed at 28 weeks of age and the entire prostates were scored histopathologically. In addition, animals were sacrificed at 12 weeks of age and ventral (VP) and dorsolateral (DLP) prostates were removed for histopathological evaluation and immunoblot analyses or ELISA.RESULTSEGCG, inhibited early but not late stage PCa in the current study. In the VP, EGCG significantly reduced cell proliferation, induced apoptosis, and decreased androgen receptor (AR), insulin-like growth factor-1 (IGF-1), IGF-1 receptor (IGF-1R), phospho-extracellular signal-regulated kinases 1 and 2 (phospho-ERKs 1 and 2), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS).EGCG, inhibited early but not late stage PCa in the current study. In the VP, EGCG significantly reduced cell proliferation, induced apoptosis, and decreased androgen receptor (AR), insulin-like growth factor-1 (IGF-1), IGF-1 receptor (IGF-1R), phospho-extracellular signal-regulated kinases 1 and 2 (phospho-ERKs 1 and 2), cyclooxygenase-2 (COX-2), and inducible nitric oxide synthase (iNOS).CONCLUSIONSThe attenuation of the AR, the down-regulation of potent growth factor IGF-1, modulation of inflammation biomarkers, and decrease in the MAPK signaling may contribute to the reduction in cell proliferation and induction of apoptosis and hence provide a biochemical basis for EGCG suppressing PCa without toxicity. Prostate 67: 1576–1589, 2007. © 2007 Wiley-Liss, Inc.The attenuation of the AR, the down-regulation of potent growth factor IGF-1, modulation of inflammation biomarkers, and decrease in the MAPK signaling may contribute to the reduction in cell proliferation and induction of apoptosis and hence provide a biochemical basis for EGCG suppressing PCa without toxicity. Prostate 67: 1576–1589, 2007. © 2007 Wiley-Liss, Inc.

There have been 2 putative prostatic cancer precursors, prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia (adenosis), but PIN remains as a well-known precancerous condition. To describe recent advances in knowledge of PIN and to better define the diagnostic criteria and differential diagnosis of PIN. Review of the pertinent literature and our experience. The presence of ductal/acinar epithelial changes including nuclear enlargement, prominent nucleoli, chromatin alterations, and luminal complexity is an easy way to identify the disorder. Four main patterns of high-grade PIN (HGPIN) have been described: tufting, micropapillary, cribriform, and flat. In addition, variants of HGPIN have also been described. Both HGPIN and prostatic carcinoma share an increased incidence and severity with advancing age and with high rates of occurrence in the peripheral zone of the prostate. Furthermore, HGPIN and prostate cancer share genetic and molecular markers as well, ...

1. The nature of muscarinic receptor subtypes in the isolated prostatic and epididymal segments of the vas deferens of the rat were studied. 2. Presynaptic receptors were characterized in segments under neurogenic transmural stimulation; postsynaptic receptors in segments without stimulation. 3. The present work suggests that the potency of ACh required to activate muscarinic receptors is higher in the prostatic than in the epididymal segment. 4. McN-A-343 was only able to induce dose-dependent contractions in the prostatic segment. 5. The pA2 value for 4-DAMP suggests that in the prostatic segment the postsynaptical ACh receptors seem to be pharmacologically similar to the ACh-M3 subtype. 6. Antagonism of the presynaptic ACh receptor subtype by pirenzepine supports the evidence that these receptors belong to the ACh-M1 subtype.

Genes regulated by androgenic hormones are of critical importance for the normal physiological function of the human prostate gland, and they contribute to the development and progression of prostate carcinoma. We used cDNA microarrays containing 1500 cDNAs to profile transcripts regulated by androgens in prostate cancer cells and identified the serine protease TMPRSS2 as a gene exhibiting increased expression upon exposure to androgens. The TMPRSS2 gene is located on chromosome 21 and contains four distinct domains, including a transmembrane region, indicating that it is expressed on the cell surface. Northern analysis demonstrated that TMPRSS2 is highly expressed in prostate epithelium relative to other normal human tissues. In situ hybridization of normal and malignant prostate tissues localizes TMMPRSS2 expression to prostate basal cells and to prostate carcinoma. These results suggest that TMPRSS2 may play a role in prostate carcinogenesis and should be investigated as a diagno...

Abstract
Introduction: Prolonged urethral catheterization can cause retained catheter
Key Words: Retained catheter; bladder stone; prostate
Case: 70 years old with BPH, with retained catheter due to huge stone, he had extraction of the stone and prostatectomy.
Discussion: our patient presented with six months prolonged catheterization and Argarwal et al reported 3 months.
Conclusion: retained catheter can be caused by stone around the tip of the catheter.

Prostatic arterial embolization (PAE) gained special attention in the past years as a potential minimally invasive technique for benign prostatic hyperplasia. Treatment decisions are based on morbidity and quality-of-life issues and the patient has a central role in decision-making. Medical therapy is a first-line treatment option and surgery is usually performed to improve symptoms and decrease the progression of disease in patients who develop complications or who have inadequately controlled symptoms on medical treatment. The use of validated questionnaires to assess disease severity and sexual function, uroflowmetry studies, prostate-specific antigen and prostate volume measurements are essential when evaluating patients before PAE and to evaluate response to treatment. PAE may be performed safely with minimal morbidity and without associated mortality. The minimally invasive nature of the technique inducing a significant improvement in symptom severity associated with prostate ...

Volumetric modulated arc therapy (VMAT) is a rotational delivery technique which offers the potential of improved dose distributions and shorter treatment times when compared to fixed-beam intensity-modulated radiation therapy (IMRT). This note describes the use of an existing treatment planning system (Philips Pinnacle(3) v.8.0), supplemented by in-house software, to produce a single-arc VMAT prostate plan. While a number of planning systems for the Elekta VMAT platform are commercially available, the use of an in-house solution has allowed more detailed investigations of VMAT planning, as well as greater control over the optimization process. The solution presented here begins with a static step-and-shoot IMRT approach to provide initial segment shapes, which are then modified and sequenced into 60 equally spaced control points in a 360 degrees arc. Dose-volume histogram comparisons demonstrate that this VMAT planning method offers multiple dose level target coverage comparable to that from a standard IMRT approach. The VMAT plans also show superior sparing of critical structures such as the rectum and bladder. Delivery times are reduced with the VMAT method, and the results of dosimetric verification, resilience and repeatability tests indicate that the solution is robust.

BPH remains one of the most common diseases that the urologist has to manage. The last decade brought numerous new techniques, aiming to improve the minimally invasive approach to BPH, but, for the moment, none had changed the place of TURP as the gold standard treatment for medium sized prostates. Based on a large personal experience, the authors present a study in which TURP is used for prostates over 80 ml, the cutoff point set by the guidelines of the European Association of Urology. The rationale for this study is that many situations require minimally invasive treatment, based on the express request of the patient, other conditions that makes open surgery very difficult or impossible, or the need for a quick discharge in an overcrowded service. The aim of the study was to prove that TURP is safe and effective even in larger prostates. The technique used is basically the classic one, with minor tactical alterations in some cases. Some cases required a two-stage approach, but of...

Resumen Context: Benign Prostatic Hyperplasia (BPH) is a common disease that course with Lower Urinary Tract Symptoms (LUTS), mainly in over 50 years-old men. Commonly indicated drugs such as alpha adrenergicblockers are life-treatment with some adverse reactions. Center for Drug Research and Development produce a microencapsulated lipophilic extract of pumpkin seed oil (Calprost) with anti-androgenic, antiinflammatory, antioxidant, antiproliferative and diuretic properties. Aims: To evaluate the effect and safety of Calprost in patients with BPH and LUTS. Methods: A multicenter, randomized, controlled, open exploratory clinical trial was conducted. Two experimental groups, study group (Calprost, 140 mg daily) (n=81), and control group (terazosin, 2 mg daily) (n=50) were conformed. All the patients were treated during three months. Efficacy was evaluated through International Prostate Symptoms Score (IPSS), residual bladder volume and prostate volume. Results: Most of the included p...